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Researchers are once again calling for large-scale epidemiological research into the link between sick crew members and air quality on board aircraft. According to neurologist Gerard Hageman, it is very likely that prolonged exposure to toxins in the cockpit and cabin can lead to serious health damage. However, a causal link has never been established. Minister Harbers for infrastructure and water management says he supports follow-up research.
In a recently published chapter in the scientific journal Advances in neurotoxicology Four authors, including Hageman, put the scientific insight into the so-called aerotoxic syndrome in a row. For many years, scientists from around the world have been trying to explain why a small minority of flight crews develop severe neurological and cognitive disorders. There are serious indications that it has to do with the poor air quality on board aircraft, but there is no hard evidence. It is therefore (yet) not a recognized occupational disease.
Many aircraft engines suffer from oil leakage. As a result, low concentrations of toxic substances end up in the cockpit and cabin. There are also so-called smoke events instead, the leak is larger and the plane is suddenly blue with smoke. In such a case, the pilot may have to land the plane as quickly as possible because passengers and crew members become uncomfortable.
What is aerotoxic syndrome?
Most passengers who get sick after such a smoke event recover quickly. But among crew members, the complaints sometimes turn out to be more persistent, and some of them even need to be hospitalized. One explanation for this could be that pilots and cabin crew are also exposed to low concentrations of toxins, such as organophosphates, during ‘normal’ flights. It can lead to hypersensitivity.
Zembla has made several broadcasts about the mysterious pilot disease. In the broadcast ‘Married in the cockpit (2017)’, we showed how scientists researching the disease are being thwarted by the aviation industry. We talked to dozens of pilots, stewardesses and stewardesses with serious health issues. Some of them have even become incapacitated. The same is the flight attendant Evelyn van den Heuvel. She filed a lawsuit because she did not receive disability benefits.
The clinical picture differs from person to person. Hageman: “Some patients have more lung problems or heart rhythm disorders, others more neurological disorders.” In the recently published study, the authors also cite other possible explanations, such as sleep deprivation, irregular shifts, jet lag, and working at great heights.
But why do some people get complaints and others not? It may possibly be related to a particular genetic susceptibility. There are indications for that. The four authors therefore insist on further research: better detection equipment on board aircraft and large-scale epidemiological research.
Toxic surveillance and extensive research on sick and healthy crew members require cooperation from airlines. And they are not eager, we showed in this broadcast. In fact, a sick KLM pilot was forced to fly again. When he finally left, he had to sign a non-disclosure agreement.
Manufacturers and airlines have denied or downplayed the aerotoxic syndrome for years. They stress that it is not certain that crew members will actually get sick from flying. According to neurologist Hageman, it is always difficult to detect a link between complaints and exposure to certain toxic substances with such disorders. It also took years before the so-called paint disease was officially recognized as an occupational disease.
In 2015, then-Secretary of State Wilma Mansveld established the National Cabin Air Advisory Group (NAC). This advisory group shall inform and advise the Ministry in this file. In addition to scientists, the NAC also includes representatives from the aviation industry. However, the quality and frequency of NAC reports has been criticized for years, as was recently highlighted in a Pointer broadcast by KRO-NCRV.
The latest NAC report (from 2021) states: “The reason for the complaints is not yet clear. One possibility is that it concerns a small group of people who, due to a genetic predisposition, are more sensitive to the health effects of certain substances. ”
When Zembla asks if the NAC believes there is a need for new large-scale epidemiological research, the answer is: “It is a question that can be asked of the members.” The NAC also states that the desirability of detection equipment on board aircraft has been discussed in the advisory group, “but it has not yet led to an advisory.”
Minister of Reaction
When asked, the spokesman for the Ministry of Infrastructure and Water Management says: “The Minister will take such advice very seriously given the importance of safety.” Further research will also be supported. “For the Minister, aviation security is number one.”
According to the ministry, RIVM is currently involved in an international study of exposure to chemical substances via cabin air.